midterm 1 Flashcards
BNA act
British north American act, 1867, created the federation union of Canada, became the constitution act in 1982
Liberal Democracy
democratic system of government where individual rights and freedoms are officially recognized and the exercises of political power is limited by the rule of law, which means that everyone must abide by the law
Charter of rights and freedoms
supreme law of canada, 1867, document lays out legislative, executive and judicial structure and authority
Department of Health
federal government of health created in 1919, became Health Canada in 1993
Federal responsibilities
aboriginal peoples, veterans, armed forces, rcmp, correctional services, temporary coverage for immigrants
Medicare
name for Canadian National Health plan
block transfer
one payment from federal government to provincial government to cover costs of all services
extra billing
an additional fee charged to the user by a health care professional for a service that is covered under the provincial health plan
Canada Health Act
1984, became law under liberal gov, goal was to provide equal and prepaid and accessible health care to eligible canadians
eligibility
Canadian citizenship; permanent resident, resident of province or territory where seeking health care services, physically resides in that jurisdiction for at least 5 months, immigrants and refugee covered federally
Criteria of CHA act
public administration, comprehensive coverage, universality, portability, accessibility
Conditions of CHA
recognition, information
Public Administrative
criteria: health plan must be managed by a public authority for a non-profit bias. all plans must be overseen by the ministry of health
comprehensive coverage
must allow any eligible Canadian with medical need access to pre paid medically necessary services. no barriers across Canada
universality
all eligible residents are entitled to all of the insured health services, the inability to pay cannot prevent access to care
portability
Canadians moving to a different prov/ ter are covered for health care by their province or origin during the waiting period (this period cannot exceed 3 months), canadians leaving the country are still insured for a period of time decided by their province
accessibility
insure that all eligible canadians have reasonable access to services where and when they are available, this applies to wait times as well
Information
province or territory must provide all info on health services provided by their plan to the federal government
Recognition
province or territory must publicly recognize the federal government financial contributions to all health services provided
Medically necessary
clinical judgment made by a physician regarding the necessity of a service provided under the plan
user charge
a fee imposed for an insured health service that is not covered by the provincial plan
primary health care reform
changes to the delivery of primary health care with the goal of providing all Canadians access to appropriate health care providers 24/7, no matter where they live
goals of the primary health care reform
team oriented care, emphasis on health, community based care, focus on health promotion, comprehensive and integrated care, collaborative care
Mazankowski Report
2001, provide strategic advice to the premier for preservation and future advancement of the quality of health services in Alberta. OUTCOME: by 2003 Alberta became the first province to implement a province wide electronic health record initiative
Kirby Report
2002, examine the state of the Canadian health care system and the role of the federal government. OUTCOME: not widely accepted but led to Ontario implementing payment premiums for health care
romanow report purpose
present recommendations to ensure the survival of Canadas health care system and to consider health promotion and disease prevention initiatives
romanow outcome
in 2004, gov. embarked 10 billion to address report, set amount from federal to provincial, limit on wait times, health council of canada was created in 2014, premiers agreed on more funding and initiatives for health care renewal. Primary health care reform initiatives implemented
Health accord
legal agreement between federal and provincial governments on health care funding
Health Canada
federal body headed by the minister of health, oversee health promotion and disease prevention (introduce campaigns), funding to provinces, ensure all provinces and territories are following CHA, research, health info resource, interacts with WHO, and travel alerts
Health ministry branches
there are 12 in total
Audit and accountability bureau
internal monitoring system
Chief Financial Officer Branch
oversees the use of health Canada’s resources and ensures finances are spent wisely, and that other departments adhere to policies and regulations
department Secretariat
executive office, acts as link between executive and political levels. other departments report to them
corporate services branch
provides support and services to health canada, and also provides language and training support
Legal Services
reporting to the department of justice, they provide legal advice and other legal services to health canada
First nations and inuit Health branch
oversee delivery of primary health care services to aboriginal people, also manages federal funding for health services to these populations
strategic policy branch
develops and implements the federal gov. health Canada health care policies
Health products and food branch
reviews health risks and benefits of drugs, vaccines, medical devices, natural health products, veterinary drugs and food
Healthy Environments and Consumer Safety branch
develops and supports programs that promote a safe healthy lifestyle and environment for canadians
Regions and Programs Bureau
comprises the regions, workplace health and public safety program and programs directorate
communication and public affairs branch
perform a number of duties involving communication activities and responsibilities (maintaining communication with health canada and the public) and marketing and communication services
pest management regulatory agency
evaluates pesticides in canada before allowing them on the market, and control pests (mosquitos-viruses) that are harmful to humans, pets and environment
Agencies
public health agency, canadian institute of health research, patented medicine price review board
public health agency
has a mandate to promote health and prevent diseases
patented medicine prices review board
monitors prices of patented drugs to ensure fairness to both manufacturer and consumer
canadians institutes of health research
directs and funds research across canada (13 research institutes), created under the CIHR act 2000
Responsibility of health ministry
maintaining and improving health of canadians, oversees health portfolio, supervising the collection and analysis of info, collaborating with provinces and territory counterparts
Canadian Institute of Health INformation
CIHI, independent organization that provides information, works with CIHR, their data is used at all levels of government
Patented Medicines Review Board
1987, under the patent act, limits prices, regulatory, reporting
international collaborators
WHO, Pan American health organization, North American Collaboration, Organization for economic cooperation and development
Provincial role
13 separate health plans, each province administers own plan, must abide by CHA, hospital care and medically necessary, each province has a ministry of health, each province determines how to pay for services not covered by the federal government
Health Ministers responsibilities (PRovincial)
implementing and regulating health plans, hospital and medical care, negotiations of salaries for health care workers
Categories of health care
primary, secondary, tertiary, quarternary
Primary health care
access to direct primary care services (doctors, nurses etc)
secondary care
referral to a specialist by a primary care doctor, short term, may result in specialized care delivery or referral to tertiary care
tertiary care
highly specialized, reffered by a specialist, may be short or long term, care usually provided by one or more specialists
quaternary care
highly specialized, not widely available, often at a facility such as a university hospital that may involve treatments that are in the final stage of research
Regional Health authorities
transition in the 1990s, defined geographic region, help meet needs of community, board governance, service centralized to regions, many small facilities were closed, some services shifted to more rural areas to keep facilities open, most provinces moved back to central health authority
4 goals of regional Health authorities
amalgamate services, health promotion and disease prevention, involve the public, implement appropriate and effective governance
move from regionalization
decrease red tape, services streamlined and easier to access, decreased admin cost, no evidence for which is better
New Brunswick health system
2 health authorities- horizon and vitalité, each has a board of directors, medavie health services- extra mural programs and ambulance nb, service nb-non clinical support
Provincial payment methods
premiums, payroll tax, general revenue, fundraising
Health Care Premiums
alberta, BC, Ontario, premium for private health care are deductible, for public are not, does not contravene Canada Health Act as long as no one is denied care, individuals may receive assistance based on income, variety of formulas determine rates
Payroll Tax
Manitoba, Ontario, Quebec and NFL, collected from employers to specifically fund health care, variety of formulas to determine tax
Private Health Insurance
60% of canadians have it, helps offset the cost not covered by provincial plan, group employment benefits help cover what is deemed as not medically necessary, drug coverage
Applying for insurance to the ministry of health
documents that are required vary: proof of citizenship, personal identification, if moving to Canada, immigrant identification number
wait period cannot exceed 3 months
Health card
applicant is assigned a # once approved, must be presented when accessing services, only provincial health care providers can request card, if health card is not valid will have to pay
Health Card FRaud
when an individual uses a health card that is not assigned to them, non-resident falsifies applicant information, difficult to detect, serous offence, health care providers watch for suspicious activity, report lost cards immediately
Private Health Care
offers services not medically necessary, diagnostic tests, some jurisdictions will subcontract services to private clinic, “boutique” clinics
Insured Medical Services
deemed medically necessary by medical doctor, must be referred by a doctor for a specialist visit, each province has a list of insured services, physicians may bill for other noninsured services
drugs
second highest health care expenditure, all provinces have prescription drug plans for social assistance, private plans have deductibles, formulary list determines what drugs are covered, lifestyle drugs not covered, prescribers need to get approval for drugs not on the list
conventional medicine
mainstream medicine, “western”, conventional health care workers is any non alternative , science based education
complementary and alternative medicine
medicine practices by health care professionals not considered conventional, not widely accepted in hospitals, patients seek
regulation of health care workers
there to serve the interest of the public; accountable to the government for living up to the deal defined by enabling legislation. regulatory bodies are there to protect the public from incompetent or unethical practicers
legislation
for health care professionals provides TITLE PROTECTION. which means only individuals who have met the criteria and are registered can use the title
Regulator methods of protecting the public
determining educational standards, standards and reviewing education programs, licensure exam that test entry level competency, a clear complaint process
health profession act in NB
new brunswick has legislation for all health care professionals
Controlled acts
procedures that must be preformed by a qualified professional (for safety of patient), identified in regulator health profession act or equivalent, expectation (individual has taken course to learn specific skill)
Delagated acts
“means by which a regulator health care professional transfers legal authority or permits another person to carry out a controlled act they are otherwise not qualified to do.”
guidelines for delegation vary, bearers of responsibility (delegating health care professional, agency, delegate)
complaints
formal process, complaints committee (determines legitimacy and course of action(dismissal, investigation, disciplinary action)) each regulator is require to have a formal complaints process
educational standards
set by regulator, include theory and clinical, entry to practice exam, competency based assessment program
licensing
provincial and territorial regulator (conjunction with education institute) almost all require annual renewal
non-regulated health care workers
no legislation or regulatory body, may have professional organization, hiring agency determines requirements, no specific standard
practice setting for health care worker
clinics, hospital, dr office, home and community, institutions, tel helplines, community health centers
Primary health care vs primary care
PHC is an approach to health and a spectrum of services beyond the tradition health care system whereas PC is an element within PHC, services are delivered by family physicians and general medical practitioners, they focus on diagnosis and treatment of illness and injury. PHC is a team of providers who are accountable for providing comprehensive services to their clients
RNs
self regulated, scope of practice: work autonomously and collaboratively, clients: individuals, families, groups, communities, populations, across life span, provide direct care services, coordinate care support clients in managing own health, leadership. Setting: Practice, education, admin, research, policy
Entry to practice (RN)
Bachelor degree(2,3 or 4 yr program) national exam (NCLEX), national council of state board of nursing, ontario nurses write jursiprudence
Nurse Practionners
entry to practice: RN w extra training and skills, masters degree, national exam specific to specialty
diagnose and treat conditions, order and interpret labs and diagnostic tests, perscibe, health educators, disease prevention and health promotion, specific controlled acts, yearly registration as NP
Clincal Nurse Specialists
masters doctoral degree, specialized knowledge, evidence based practice, leadership positions, CNS is not a protected title, yearly registration as RN
RPNs
Registered Psychiatric Nurse, separate regulated profession in Western Canada (degree level, med and surgical skills along with mental health)
Focus: mental/developmental wellness, mental illness, addictions, substance misuse
hospitals, community, crisis stabilization and assessment unit
LPNs
entry to practice; 2 yr program, Canadian PRactical Nurse Registration Examination (CPNRE)
expanding skill set
hospitals, longterm, home care, community
collaborative w RN and other team members
association of NB LPN (ANBLPN)
National standards for RNs
canadian Nurse association (CNA) -national and global voice for canadian nurses - advocated for nurses and health care - committed to public funded - not all jurisdictions are members - administer CRNE until NCLEX framework for practice of RNS in Canada - code of ethics
NB nursing regulations
nurses act (1984, ammended in 1997 and 2002) protects nurse title, nurses association of Nb (NANB)-->self regulation: promote good practice, prevent undesirable practice, intervening in unacceptable practice when necessary -public protection
NANB
board of directors: association governing and policy making body, on behalf of RNs in NB, the board ensure the association achieves the results defined in the Ends policies in the best interest of the publiv
NANB structure
president and president elect (2 yr term as elect, then 2 yr as pres)
7 regional directors (elected by members) (3 year term)
3 public directors (2 appointed by LG, 1 from minister of health)(3 year term)
NANB staff
president and executive director, regulatory (registar and quality assurance program manager, general council, nurses coalition), practice (senior advisor, nursing education and practice, nurse consultant) corporate services, communications
NANB Registration services
new nb grads, registration exam, registration verification, registration renewal, registration reinstatement, NP registration
NANB Membership Services
nurse practice consultations, nursing standards publication, professional journal, continuing education, legal services. NANB provides members services that can both benefit them in their practice and in their practice of nursing
NANB complaints and discipline
mandatory reporting:
RNs unable to function safetly, dismissal of RN related to incompetence or incapacity, incidents of sexual abuse
how to lodge a complaint NANB
contact regulatory consultant
How complaints are handled
nurse and employer immediately notified (submit relevant info), complaint committee meet (3 members, 2 rns, 1 public) either dismissed or referred to disciplinary or review committee, which holds a hearing (4 members 3 RNs, 1 public) nurses and complainant may attend, testimony received, committee decides outcome
disciplinary committee
other issues than health related
review committee
health related issues
discipline decisions
decision is delivered promptly to nurse, complainant and employer, public notice must be given of any suspensions or revocations (posted online), public can check registration at any time
